Is this legal

[pamb]

I am working as a consultant for a state funded childrens home. Medical staff are not required. I was monitoring a med pass for the purpose of correction and teaching. A child came to the home as a respite client. His medication was in a used pill bottle for another patient. The information was covered up with a piece of paper with the respite kids name hand written on it along with the instructions to give bid. I was told that this med was an antibiotic for a spider bite. There were 4 pills in the bottle. I told staff not to give the meds and the reasons why. Not in original container, no dr. order, no name of medication etc. The supervisor was called and told staff just to wait until I left to give it. I was reprimanded the next day and it was implied that I was not a team player , that I should not have told staff what I thought...don't give the medication, and that what they did was perfectly acceptable. As I see it there are at least 3 state funded facilities that did not follow safe standard medication administration policies in this situation. The home from where the child came from, the medical consentor-case manager from CPS and the facility that I work for. This situation has me really bugged. Any feed back.

[Magsulfate, BSN, RN]

Well, we can't give any legal advice in this forum. But that sounds reaaallly fishy to me!!

I know that at public schools, there must be the origional prescription bottle, with the dr's name on it, date, directions, child's name,, etc. . Heck, i don't even think I would do that to medications in my OWN HOME, much less a place run by state health insurance!

I just don't know what to say about this!

[mscsrjhm]

Went through something like this a few years ago. Luckily, my state has legislation regarding non-retaliation toward whistleblowers. I don't know what I would have done without it.

You are really stuck between a rock and a hard place. Consulting firm informing you to keep quiet- state facility not following it's own policies. If you report it- probably nothing will happen except you could lose your job.

If you decide to go that route-reporting- this incident will probably be viewed as one minor isolated infraction, only one- it will probably be brushed aside.

Who do you report it to? State? State departments try to avoid stepping on other state employees' toes inside the system.

No, the medication should not have been given. It was obviously not prescribed to that client, and this is wrong in every direction. Your directions were correct, as you already know.

Tough spot. I really do feel for you.

A properly worded letter, trying not to step on toes, expressing concern for the child, and maybe a copy of the medication policy might work. But, you already know that it might not.

It would help if you had any friendly connections in the system.

Good luck.

Be on the look out for another job, just in case you decide to push it.

[green_serenity]

PLease take the time to view

"When a nurse is a criminal defendant part 2" on you tube...

I guess it would be a great help for you...

[deyo321]

This just sounds all wrong to me. Medical staff are not required but you're monitoring a med pass? There are unlicensed people passing meds to children in state run facilities? That seems nutty to me. Maybe because they don't have licenses they don't run the risk of losing them? All nurses are shuddering at what you have described. It just breaks so many of our cardinal tenets.

[groovy jeff, RN]

Not a lawyer (would never be, ever, ever); however, one of these days some kid is going to get the wrong meds. In my past life I had my own company and did consulting work; the money is great when you can get the work. So there in lies the "pickle"; do you snitch and lose your job or the contract- OR -do you go along. It sounds as if the folks that are saying that your not a team player are not medical people. If this is the case, I would try my best to educate them on the danger. If they are administrators or HR types, they will cower at the word "liability". At any rate I would make sure to submit a detailed report to my superiors, with your input on the dangers, and keep a copy (mail it to your house and don't open it so it has a dated postmark). Tough situation; best of luck.

Happy Holidays & Stay Groovy

[Vito Andolini]

Wow, nothing I can really add to the advice you've already received. I'm just wondering what type of outfit you work for - privately owned, I guess. But why bother to hire you as a consultant if they don't really want you to consult?

I think you might have liability if you DON'T report this to authorities. I'm not sure, of course, but I'd really be scared NOT to report it to whoever licenses this place. And even if they can pass meds without a licensed person, they still, I'd bet, have to meet some sort of requirements to be open, caring for children.

I think what I'd do is first get myself a lawyer because I know I'm going to have a legal battle on my hands, no matter what I do or do not do. At least, I'd get a free consultation with a couple of lawyers. Then, I'd speak with my boss to find out why what I did was wrong (telling them not to give the med). And I might go on and report the Administrator's response (give it after I'd left. Oh, and how do you know that's what was said and done? Are you positive?)

I know a lot of people would look at the situation and say - well, the kid suffered no harm, so just do some quiet teaching and forget about it. I guess you have to decide what approach to take, how big a thing to make out of this. Doesn't it just bite your butt that life is like this?

But good luck and I hope it all does not come back to hurt YOU.

[pamb]

This is a not for profit emergency shelter that accepts medicare payment. They have very clear medication administration guidelines from medicare. I have reviewed the guidelines as I gave medication training in the fall. I did not see exceptions to the rules.

When the supervisor was contacted that night, I spoke to her and told her I could not support giving the medication. She said that she would just come and give it. I said that would be fine. She called a few minutes later and spoke to the staff I was training. He said, she said ,"just don't worry about it." I left about 930. I came back the next AM and saw the med had been signed out at 945. The med sheet had the childs' name on it. and the times filled out for the night I was there as well as in the morning. The rest of the sheet was blank.(of course, they don't know anything else!) The person that usually signs behind him refused to do so. That is pretty good confirmation that the administration can do what they want to. The eye contact from the guy that gave the medication was absent towards me. So sad.

I have the administrators respose on an email I copied. "I am the adminstrator and what we did is within our guide lines" "As the director I have to make decisions like this" They also used the medical consentor term a lot. My take on that is, this is a social worker with child protective services that stretched his authority just a little too far. Naming a medical consentor is an attempt to have checks and balances in place, a way to prevent meds from being prescribed that aren't neccessary.....He too is in violation of the medicare med. admin. guidelines as far as I am concerned.

I do feel confident that this kid will be ok and that the medication is probably what they say it is.

One of the things that is so frustrating is if I make a big stink they will just get rid of me and continue to do as they are. I don't think reporting this is going to affect any change, just headache for me. I have consistantly run across unethical behavior like this as a nurse.The politics are awful. I had been out of nursing for 5 years due to this kind of stress and trying to do the right thing. I thought this would be a nice calm way back into nursing and I would be helping the kids and education staff. What I have found is staff thinks they are educated enough.LOL

I decided to post in here cause I wanted support and confirmation. Thanks to all of you who have responded.

Yes this job is going to be short term. I can't work for a place that I can't feel proud of. I have made some small difference while I have been there tho.

[GrumpyRN63, ADN, RN]

totally not kosher IMHO

[kythe, LPN]

In behavioral group homes I am familiar with, all medication is individually bubble wrapped and all meds must be signed out with the time, date, and initials of the employee responsible. Non-medical homes do not require licensed personnel to administer meds, but they do take precautions against med errors. I know nothing of legalities, this is just my personal experience with a particular company's policy.

I am wondering why they wanted you to monitor this med pass if they didn't intend for you to critique it. Did they need a licensed person to sign some documents? Personally, I would be very careful about documenting such an event when management appeared so eager not only to allow it but to encourage this action. It may not appear that there were problems with the child taking this med, but if they treat medications so casually, what other short cuts they are taking when it comes to these children's care? I would seriously consider reporting this to an outside authority.

[BabyLady, BSN, RN]

What I see out of the situation, is that I can understand the reason why you didn't want the medication given, but no one seemed to make any provisions to have the child properly treated, especially for a spider bite. It was not in the child's best interest to just stop the medication without anyone having any direction of what is to be done next.

[Magsulfate, BSN, RN]

I am wondering why they wanted you to monitor this med pass if they didn't intend for you to critique it. Did they need a licensed person to sign some documents? Personally, I would be very careful about documenting such an event when management appeared so eager not only to allow it but to encourage this action. It may not appear that there were problems with the child taking this med, but if they treat medications so casually, what other short cuts they are taking when it comes to these children's care? I would seriously consider reporting this to an outside authority.

Right.... okay... so they hired you to audit them.... why.... here's why, BECAUSE MEDICARE/MEDICAID wants to make sure they're doing stuff right,, and if they're not, they will stop paying them. I can bet you that they were forced to hire an auditor to be able to continue to bill medicare/medicaid.